儿童玻璃体切割术后无晶状体眼行人工晶状体睫状沟缝线固定术的临床观察

目的　评价玻璃体切割术后儿童无晶状体眼行人工晶状体睫状沟缝线固定术的有效性及安全性。方法　回顾分析２００５年至２０１５年在河北省眼科医院眼外伤科行玻璃体切割术后人工晶状体睫状沟缝线固定术４８眼（男２８眼，女２０眼）的术后并发症、眼压、人工晶状体位置，并比较手术前后视力、屈光状态。结果　术后出血８眼（１６．７％），低眼压３眼（６．３％），一过性高眼压及角膜水肿４眼（８．３％），经保守治疗后均恢复，没有出现明显的人工晶状体倾斜和偏心以及人工晶状体襻缝线脱落。术后末次随访时视力较术前提高（Ｐ＜０．０５）。屈光度数预测值与术后３个月实际屈光度数无显著差异（Ｐ＞０．０５）。屈光度数预测值与实际屈光度数偏差:４０眼（８３．３％）＜１．５０Ｄ，６眼（１２．５％）１．５０～２．００Ｄ，２眼（４．２％）＞２．００Ｄ。结论　人工晶状体睫状沟缝线固定术对玻璃体切割术后的儿童无晶状体眼的治疗安全有效，但仍不能忽视其并发症的出现。

Ciliary sulcus fixation of posterior chamber intraocular lens in aphakic children after vitrectomy

Objective To evaluate the efficacy and safety of ciliary sulcus fixation of posterior chamber intraocular lens in aphakic children with inadequate capsule support after vitrectomy. Methods A long-term retrospective review of 48 eyes of 48 children ( male :28 .female :20) who underwent ciliary sulcus fixation of posterior chamber intraocular lens after vitrectomy at Hebei Provincial Eye hospital from 2005 t0 2015 were evaluated for the postoperative complications . intraocular pressure and position of intraocular lens. Also, the preoperative and postoperative visual acuity and refractive status were compared respectively. Results After the surgery ,the transient intraocular hemorrhage occurred in 8 eyes ( 16. 7% ) , hypotony in 3 eyes ( 6. 3% ) , ransient high intraocular pressure and corneal edema in 4 eyes ( 8. 3% ) , yet all were cured by conservative treatment. There was no case with obvious tilt and decentration of intraocular lens and with suture breakage inducing intraocular lens falling off. In addition, all the cases were generally experienced an visual improvement according to the last postoperative follow-up (P < 0. 05 ) . No obvious difference between target refraction and actual refraction at postoperative 3 months was discovered ( P > 0. 05 ) . and difference between target refraction and actual refraction was within l. 5 D in 40 eyes(83. 3% ) .1. 5 -2. 0 D in 6 eyes ( 12. 5% ) , and more than 2. 0 D in 2 eyes(4. 2% ). Conclusion The ciliary sulcus fixation of posterior chamber intraocular lens after vitrectomy is safe and effective for the aphakic children.however the possible complications should not be neglected.